| NPI | 1568543676 |
|---|---|
| Former Legal Business Name | IMCS OF PR |
| Entity Type | Organization |
| Authorized Contact | NELIDA GOMEZ President 787-726-9620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |